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HomeMy WebLinkAboutPV2022-132 - Misc (2)VV2�,)22- 1�2- vl1 ;-1 CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 I Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 SOLAR CONTRACTOR DECLARATION Keep with Inspection card. This form is for the Inspector to take at time of final inspection PART 1: To be completed BEFORE PERMIT ISSUANCE JOBSITE ADDRESS: CONTRACTOR NAME: CONTRACTOR STATE LICENSE #: (?J Sa� Sd fcr PANEL MAKE #: PANEL MODEL #: Q �'I ©`��13?h11f1�� Y PART 2: To be completed PRIOR TO INSPECTION REQUEST and placed with jobsite inspection card 01 X01 W-3 ZT-A 9 M Z I, (�� metes- declare that the PV module make and model (PRINT NAME) number, quantity, and location are installed as per the approved plans. Module manufacturer, make, model and number, fire classifications of modules, and brackets match the approved plans for the project located at the above referenced address within the City of Newport Beach. SIGNATURG) (DATE)